Cervicovaginal matrix metalloproteinase-9 and cervical ripening in human term parturition

• Published in: European journal of obstetrics & gynecology and reproductive biology 2009-01, Vol.142 (1), p.43-47
• Main Authors: Choi, Suk-Joo, Jung, Kyung-Lan, Oh, Soo-young, Kim, Jong-Hwa, Roh, Cheong-Rae
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Body Fluids - enzymology; Cervical ripening; Cervical Ripening - physiology; Cervicovaginal fluid; Cervix Uteri - enzymology; Delivery. Postpartum. Lactation; Diseases of mother, fetus and pregnancy; Disorders; Female; Fetal Membranes, Premature Rupture - enzymology; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; Matrix Metalloproteinase 9 - metabolism; Matrix metalloproteinase-9; Medical sciences; Obstetrics and Gynecology; Parturition - physiology; Pregnancy; Pregnancy. Fetus. Placenta; Premature rupture of membranes; Term labor; Vagina - enzymology
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2008.08.009

Abstract Objective To investigate the changes of matrix metalloproteinase-9 (MMP-9) in cervicovaginal fluid during pregnancy and its association with parturition. Study design A prospective study was conducted on nulliparous women between 16 and 42 weeks with normal singleton pregnancies in the following categories: (1) preterm control ( n = 39); (2) term labor induction without labor or rupture of membranes ( n = 68); (3) term spontaneous labor with intact membranes ( n = 42); (4) term premature rupture of membranes ( n = 24). The MMP-9 concentration in the cervicovaginal fluid was measured by immunoassay. Results (1) Cervicovaginal MMP-9 did not change significantly with advancing gestation until 37 weeks, and significantly increased after 37 weeks. (2) Cervicovaginal MMP-9 levels were similar in women with no labor, spontaneous labor, and premature rupture of membranes at term. (3) For the induced labor group, a high Bishop score (≥4) was significantly correlated with cervicovaginal MMP-9. However, an elevated cervicovaginal MMP-9 did not predict achieving active phase of labor or vaginal delivery after labor induction. Conclusion Cervicovaginal MMP-9 correlated with cervical ripening before labor at term. However, cervicovaginal MMP-9 did not change with spontaneous labor or rupture of membranes at term and did not predict success of labor induction.